Application for a licence to keep a dangerous wild animal A person keeping a dangerous wild animal within the city of Southampton is required to hold a licence from Southampton City Council. The animals covered by this law are listed in the appendix box below. Pet shops, Zoos, Circuses and places registered under the Cruelty to Animals Act 1976, for the purpose of performing experiments, do not need a licence. A licence relates to the year in which it is granted or to the following year. A licence is valid from the date of issue until the end of the year to which it relates and shall then expire. Licence renewals are valid from the 1 st January or the date the application is received which ever is the later. The Dangerous Wild Animals Act 1976 requires Southampton City Council to charge a fee as part of the application. Returning your application Please return your completed application to Regulatory Services (Neighbourhoods), Southampton City Council, 5th Floor, One Guildhall Square, Southampton SO14 7FP. If you have any questions please contact the Public Health Services on 023 8083 2531. Paying the licence fee You can make payment by debit/credit card or cheque/postal order - please note that your licence cannot be issued until payment has been received. If you have any questions regarding payment please contact the Admin Section on the above number. Check the fee I enclose cheque/postal order to the value of £ Applicant’s details Full Name Age Home address Postcode Home telephone number Mobile telephone number Premises details Address and telephone number of the place where the animal will be kept (if different from above) Details of another contact (eg key holder in case of emergency) Name Home address Postcode Home telephone number Mobile telephone number Who will temporarily look after the animal in an emergency? Full Name How much experience of dealing with this animal do they have? Full Postal Address Postcode Telephone Number Mobile Number Who could re-home the animal permanently (ie if an emergency occurred)? Full Name Full Postal Address Postcode . Telephone Number Mobile Number Arrangements Species of animal(s) to be kept (scientific and common name) Number of animals to be kept Do you intend to breed from this animal? What specific risks are associated with this animal? (eg is the animal poisonous) YES [ ] NO [ ] What precautions will be taken to ensure your health and safety, that of the public and the absence of nuisance to neighbouring residents? Have you informed the emergency services (e.g. Police) about this application? Description and dimensions of accommodation to be used How much experience in dealing with this animal do you have? Description of food to be supplied Where is the food obtained? Details of your Vet Name Address Postcode Home telephone number Mobile number YES [ ] NO [ ] Please attach a copy of your insurance policy, which indicates the policy number, expiry date and the total amount of cover. Note that public liability should typically be NOT less than £1.000.000. Have you checked whether you need planning permission? Have you been convicted of an offence under the Dangerous Wild Animals Act 1976 or under the: 1. Protection of Animals Act 1911 – 1964; YES [ ] NO [ ] 2. Protection of Animals (Scotland) Act 1912 – 1964; YES [ ] NO [ ] 3. Pet Animals Act 1951; YES [ ] NO [ ] 4. Animal Boarding Establishments Act 1963; YES [ ] NO [ ] 5. Breeding of Dogs Act 1973 (as amended); YES [ ] NO [ ] 6. Animal Welfare Act 2006 [sections 4, 5, 6(1) & (2), 7, 8, 9 & 11] YES [ ] NO [ ] Conditions Please note that Southampton City Council will not grant a licence unless: 1. It will not be contrary to the public interest on grounds of safety, nuisance or otherwise to issue a licence; 2. The applicant is suitable; 3. Animals will; be held in a secure accommodation suitable in size for the animals kept and which is suitable as regards construction, temperature, lighting, ventilation, drainage and cleanliness and have adequate and suitable food, drink and bedding and be visited at regular intervals. Be appropriately protected in case of fire or other emergency; Be subject to precautions to control infectious diseases; Be provided with adequate exercise facilities. The Local Authority is required to specify conditions which: 1. Require the animals to be kept only by persons specified in the licence; 2. Require the animals to be normally held at the premises specified in the licence; 3. Require the animals not to be moved from those premises unless in circumstances allow for in the licence; 4. Require the licence holder and person keeping the animals to be insured against liability for damage caused by the animals to the satisfaction of the Local Authority; 5. Restrict the species and numbers of animals; 6. Require a copy of the licence to be made available by the licence holder to persons entitled to keep the animals; and 7. Any other conditions necessary or desirable to secure the objectives above. If you would like more information about these conditions please contact the Animal Welfare Officer. Declaration I agree to permit an officer or vet authorised by Southampton City Council to enter and inspect the premises to which this application relates before any licence is granted. I declare that the above information is complete and true to the best of my knowledge and belief. Signed ………………………………………………………… Date: ……………………………………………….. Please print name: ………………………………………………. Capacity (if application signs on behalf of a Company or Partnership)